Should You Give Injectables a Shot for Osteoarthritis Pain?

A number of injectables, including corticosteroids and hyaluronic acid, are now available to treat painful knee osteoarthritis.

WebMD—October 7, 2009

Finding relief from knee pain can be a trying experience for the nearly 27 million Americans who live with osteoarthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) help many, but these medications can have serious side effects, including ulcers and serious gastrointestinal bleeding. What’s more, supplements such as glucosamine and chondroitin, which were once hailed as miracles, have not always lived up to their claims in clinical studies.

Although joint replacement surgery is an option for many with advanced osteoarthritis (OA), new types of injections may help postpone the need for knee replacement surgery - and help relieve pain in people who are not candidates for the surgery.

“Using injections to treat OA is becoming more mainstream,” says Jennifer L. Solomon, MD, an assistant attending physiatrist at Hospital for Special Surgery in New York City. “These are good options that can improve quality of life, especially for people who can’t undergo joint replacement.”

Hyaluronic Acid Injections Can Help OA

Joint-lubricating injections of hyaluronan or hyaluronic acid also play a role in treating OA. Known as viscosupplementation, these injections basically replenish a substance found in normal joint fluid called hyaluronic acid. Several brands are available, including Euflexxa, Hyalgan, Orthovisc, Supartz, Synvisc, and Synvisc-One.

When injected directly into the knee, these OA treatments allow the cartilage surfaces of the bones to glide over each other more smoothly. They also act as a shock absorber to cushion your knee joint. Although these injections are only approved for the knee, some doctors use them for other arthritic joints, Solomon says.

Hyaluronic injections can help postpone the need for knee replacement surgery in people who have not had success with other OA treatments; but the injections don’t work for everyone. Even if they do work, there can be a large degree of variability in the response, Solomon says.

Treating OA With Stem Cells and Growth Factors

There are other promising experimental injections for treating osteoarthritis on the horizon. Solomon is one of a growing cadre of doctors using the body’s own stem cells and growth factors to stimulate the cartilage’s natural healing process.

“We take blood, isolate the growth factors in the blood, and inject them back into the knee,” she says. “There is not good hard evidence out there yet, but my clinical experience is that it works,” she says.